Breast Lift

Many women notice that their breasts do not look the same as they did when they were 20 years old. Breast tissue undergoes rather predictable changes as women age. And the changes are often exacerbated with weight gain and loss or pregnancy. The volume in the upper portion of the breast declines as the tightness in the skin at the bottom of the breast relaxes. Often, the position of the nipple and areola start to descend on the breast giving it a less “perky” appearance.

Why choose Dr. Stoeckel?

Breast lift surgery is quite technical and the results are quite technique dependent. Dr. Stoeckel has adopted several techniques that are able to optimize breast shape and minimize scarring. The horizontal scar in the breast crease seen with more traditional techniques is almost always avoided. The internal sutures that Dr. Stoeckel uses can help restore the shape of the breast without having to rely upon the overlying skin.

What changes in breast shape should I expect?

The nipple areolar complex is elevated. More skin is now visible below the areola which improves the “droopy” appearance of the breasts.

Elevated position

Breast lift surgery can elevate the position of the nipple and areolae and help improve the shape of a sagging breast. But it does not tend to add much volume to the upper portion of the breast.

These severely dilated areolae are now proportionate to the size of her breasts after mastopexy surgery.

Areolae size

The areolae are typically made smaller in diameter and the shape of the breast is improved. Patients have different opinions about the ideal size of the areolae. But most agree that too big is not preferred.

The dependent portion of the breast is no longer “pointing” downward. The heavy appearing breast is now more “perky” and youthful.

Elevated breast crease

The actual level of the breast crease is elevated with the vertical breast lift technique. The breast should no longer “droop” and wearing a bra after a successful surgery should be optional. The elimination of the “sagging” of the breast is most visible on a profile view.

When is a breast implant needed with a breast lift?

Typically, a breast implant is needed to achieve a breast shape that has more volume and looks fuller. This can be done with a breast lift surgery to both improve the shape and volume of a deflated breast. There are certainly more risks when implants are added to breast lift surgery, but they are often necessary if increased upper pole volume is a major goal.

Improved shape and increased volume with both implants and a breast lift

Where are the scars for a breast lift?

Breast lift surgery is very effective for many patients in correcting poorly shaped breasts. But it has its limitations and its drawbacks. The most obvious is the scar associated with the surgery. The only way to tighten the skin envelope of a “droopy” breast is to remove some tissue (mostly skin). Doing so requires the placement of a scar. The good news is that the scar typically heals much better than most women assume. The scar associated with the breast lift technique required by most patients is one that is comprised of a vertical component below the areola and a circular one around the areola. Many people refer to this as a lollipop lift, circumvertical lift, or vertical breast lift. The technique allows for both removal of excess skin to help tighten the loose skin envelope, but also allows for the placement of sutures under the skin that helps to reshape the actual breast tissue itself. By placing sutures in the actual breast tissue, much of the stress on the skin stitches is relieved, which drastically improves the resultant scar. The scar around the areolae tends to be much more stable and significantly less likely to widen with time, which is a problem with “skin only” breast lift surgeries.

Is there a way to avoid the vertical scar?

For a select few patients, the vertical scar can be avoided. The donut breast lift or circumareolar breast lift can be used in patients that need very little “lifting” of the breast tissue. It is a way to slightly elevate the position of the nipple more than a true breast lift procedure. But it can be very effective for the right candidate. The major difficulty with this type of lift is to minimize how much the circular scar around the areola widens over time. Dr. Stoeckel uses a permanent “purse string” suture to help control this problem.

Should breast lift and breast augmentation be completed at the same time?

Breast augmentation involves adding volume to the breast in hopes of expanding the existing skin envelope, filling it out, or just making it bigger. Breast lift surgery involves trying to remove the excess skin, reshape the existing breast tissue into a more compact and tighter geometry, and in general tighten the breast. These two procedures tend to “fight against each other” when done together. One is trying to stretch while the other is trying to tighten. For this reason, simultaneous breast augmentation and breast lifting can result in a higher risk for unsatisfactory scarring, especially when using large implants.

Both procedures also take significant amounts of time before the final results of the surgery are visualized. Breast implants alone often take 3 months before they are softened and settled into the pockets in a natural way. Breast lift surgeries often look overly tightened for a period of time as well. Trying to make exact determinations about how much skin needs to be removed and how tight the lift should be made to match with a particular implant is often difficult. For that reason, breast lift and augmentation combination surgery is probably one of the highest revision rate procedures that is performed.

Staging these surgeries does allow for a more precise end result in many cases. With that being said, most surgeons perform breast lift and augmentation together in a single procedure. And often the results are great. Dr. Stoeckel most often performs the procedures together when the patient is certain that both the lift and augmentation are desired. Patients need to understand that the surgery, when combined, does have some challenges in precision and revision surgery is often needed for optimal results.